CODE: CARE/20_________

MINISTRY OF SPORT AND COMMUNITY DEVELOPMENT

Community Action for Revival and Empowerment (CARE) Funding
All applications are to be submitted two months in advance of the event date.
For official use only:
Date of Application: Date of Project/Activity: Date of receipt of completed application :
____/_______/________
29 07 2025 ____/_______/________
23 08 2025 ____/_______/________
day month year day month year day month year
Instructions
1. Please answer questions on this form in BLOCK LETTERS 4. Additional information should be submitted along with application
and write with Black or Blue ink. as necessary.
2. Do not leave any fields blank. Put N/A if field does not apply. 5. Form must be completed, signed and witnessed by the
3. All applicable supporting documents must be submitted President/Head (Chairman/Chief Executive Officer/ Director/
along with the completed application form. Owner/Founder, etc) of the organization.

SECTION A: PROJECT SUMMARY

Name of Project/Activity: MALABAR FUNDAY & SPORTS DAY

Venue of Project/Activity: FLAMBOYANT PARK, MALABAR PHASE 1, MALABAR
Total Budget (TT$): Amount Requested from MSCD (TT$): 200,000

SECTION B: INFORMATION ABOUT YOUR ORGANIZATION

Name of Organization: UNITY FOR CHANGE
Type of Organization: (Tick appropriate box)

Community Council/Community Children and/or youth organization Environmental Organization

Development Organizations
Women’s group Faith-Based Organization (FBO) Sport
Non-Governmental/Service Cultural Group/Organization Other (specify)
Organization (NGO/SO) National Association/Parent Body _________________________
Mailing Address: #74 VICEROY CRESCENT, BON AIR GARDENS , AROUCA
Phone(s): 1868320-6060 Fax:
Email: [email protected] Website:
Meeting Address (if different from mailing address):

Date Founded: ____/_______/_______ Date of last Annual General Meeting (AGM) ____/_______/_______ Not Applicable
day month year day month year
Incorporation/Registration Status and date of Incorporation/Registration (tick all that apply):

Incorporated by an Act of Parliament Registered Not-for-Profit under the Companies Act

____/_______/_______ ____/_______/_______
day month year day month year
Registered with Government Ministry (name) Registered with the National Registry of Artists and
____________________________________ Cultural Workers
Date of Registration ____/_______/_______ Date of Registration ____/_______/_______
day month year day month year
Registered with Ministry of Sport and Community Development
Date of Registration ____/_______/_______
day month year
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Bank Information:
Does your organization have a bank account in its name? Yes ■ No
Name of Bank: ______________________________________________________________________________
Name on Account: ___________________________________________________________________________
Name of Signatories: ____________________________ ____________________________
____________________________ ____________________________

Executive contact / Project Liaison Person:

First list the two main contact persons for questions on this application
Name Position in Group Telephone Nos.
1. KEISHA MONCRIEFFE DIRECTOR, COMPTROLLER 320-6060
2. DEANNA ROBINSON DIRECTOR, SECRETARY 266-4166
3.
4.
5.
6.
7.

SECTION C: INFORMATION ON PREVIOUS SPONSORSHIP/ACTIVITIES

Have you previously received project funding from this Ministry? Yes [ ] No [ ■ ]

Have you previously received project funding from other Ministries? Yes [ ] No [ ■ ]

Please indicate the most recent projects for which funding was granted from any Government Ministry?

Source of Funds Purpose of Funds Amount $ Year

1.

2.

SECTION D: INFORMATION ON THE PROJECT PROPOSED

Project Title:
Project Type: Please tick the relevant area(s) below indicating the type of project.
Social events (e.g. Mothers’ & Fathers’ Days, Awards Functions, cultural events, community concerts etc.)
Employment and entrepreneurial development and income generating projects
Health and wellbeing
Furniture and equipment for community services
Training & capacity building
Children, adolescents and youth development programmes
Family life (Parenting seminars, parent/adolescent/teen relationships workshops, family life management)
Environmental enhancement
Other (please specify): ____________________________________________________________
SPORTS, FUN ACTIVITIES, WALK

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 FaLAMBOYANT PARK, PHASE 1 MALABAR, MALABAR
Project Site (where will the project take place): _____________________________________________________

Project Duration: 23 08 2025

From: ____/_______/_______ 23 08 2025
To: ____/_______/_______
____________________days/weeks/months
1 day month year day month year

Problem Description (Please explain/describe the problem or community need the project is seeking to address):
The community lacks engaging activities that promote social bonding and unity among residents.
____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Project Objectives (Please list in bullet form what the project hopes to accomplish):
Foster stronger community bonds and social cohesion.
____________________________________________________________________________________________
Improve overall community well-being and happiness.
____________________________________________________________________________________________
Encourage active participation and volunteerism within the community.
____________________________________________________________________________________________
Help change the stigma of others outlook on the community.
____________________________________________________________________________________________

Project Activities (Please list the key activities of the project designed to accomplish stated objectives):
Novelty Events
____________________________________________________________________________________________
Change Walk
____________________________________________________________________________________________
Foot ball & other sports
____________________________________________________________________________________________
Bouncy Castles and more
____________________________________________________________________________________________

Proposed Beneficiaries (Please describe the target population to be served e.g. Vulnerable children & youth, elders, all community members):
All community members
____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Estimated number of persons to be served by the proposed activity:

(Insert relevant age range e.g. (0-6, 7-12, 13-18, 19-24, 25-30....65 and over etc.))

Age-range Age range Age-range Total

Male 0-65 and over 300
Female 0-65 and over 300

3
Collaborators: (Indicate the organizations or agencies with whom you are partnering on this project)
Organization/agency Roles /responsibility

Are any approvals from other agencies/ individuals required to commence the project? Yes No
If yes, please indicate in the space below the name of the agency/ individual and the approval needed:
Arima Borough Corporation for venue
____________________________________________________________________________________________
Ministry of Sports and Community Development for funding assistance
____________________________________________________________________________________________

SECTION E: INDICATORS OF PROJECT SUCCESS

What will be the evidence that your project was a success? (e.g. number attended, participant feedback)

1. PHOTOS

2. EMAILS

3. SOCIAL MEDIA
SECTION F: INFORMATION ABOUT YOUR PROJECT’S ESTIMATED BUDGET

What is your organization’s financial contribution to the project? $___________________________

Have you applied to any other state agencies and/or private organisations for support to this project? Yes No
If yes, please provide detail:

State Agency/Private Organisation Purpose of Funds Amount ($) Status

All Part Nil DK*

* DK - Don’t Know

Total Project Budget: $________________________ Total amount of funds raised: $_______________________

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Amount of funds now requested from the MSCD: $____________________________
Proposed use of funds requested from the MSCD:
____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Main budget items and associated costs

Budget items Costs

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

TOTAL

Donations or in-kind contributions

Good or Services Provided by Value

5
 CHECKLIST

Note: Supportive documents must be attached to this form. Fields with ** are mandatory.
1. Copy of Group’s Registration Certificate
2. Three quotations for every budget line item that the applicant is applying for, (must be submitted from reputable service providers.) **
3. Name & picture identification of persons authorized to collect cheque on organization’s behalf **
4. Identification from signed applicants. **
5. Confirmation of Organisation’s Trinidad and Tobago Banking Information. Verify banking information to confirm correct spelling of
the name on the organisation’s bank account by submitting a bank statement/letter from the bank (white off account number)
which must be stamped and signed by the bank. In the absence of a bank account, submit a letter addressed to the Permanent
Secretary on request to pay the supplier/s. **

DECLARATION

By signing this application we hereby warrant and undertake that:

We possess the authority to act on behalf of the Organisation hereinbefore named in relation to the Application for grant funding;
To the best of our knowledge and belief, the information supplied in this Application is true and correct;
The grant, if approved, will be applied only to facilitation of the activities outlined in this Application;
We have read and agree to the Criteria and Requirements for Financial Assistance from the Ministry of Sport and
Community Development (hereinafter 'MSCD') which is itemized in the application procedures document;
We shall submit to the Grants Secretariat, MSCD upon completion of the activities described within this Application, a Project
Completion Report along with media including but not limited to, photos, video recordings and audio recordings of the activities
described in this Application; and
We shall permit the MSCD to record in any format, all or any part of the activities outlined within this Application, and/or to obtain all
necessary permissions facilitate same, and/or to authorize the MSCD to use any such recordings made by the MSCD or any media
submitted by the Application in any form whatsoever for purposes including but not limited to archival, reporting or promotional purposes.

KEISHA MONCRIEFFE
Name: ___________________________________________________ 1868266-4166
Mobile: ___________________________

DIRECTOR, COMPTROLLER
Position in Organization/Group: _________________________________________________________________

Signature: ________________________________________________ Date Signed: ______________________

Stamp Here
Official Stamp of Organization/Group

DEANNA ROBINSON
Name of Witness: __________________________________________ Mobile: ___________________________

DIRECTOR, SECRETARY
Position in Organization/Group: _________________________________________________________________

Signature: ________________________________________________ Date Signed: ______________________

PLEASE RETURN COMPLETED FORM TO:

The relevant Community Development Division (District Office)

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 FOR OFFICIAL USE

Group Registration Status: _____________________________________________________________________

Verification of bank information:

Name(s) on Account ____________________________________

Comments on Project: ________________________________________________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Other Comments (recommend/not recommended and reasons): _______________________________________

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Assessment criteria evaluation form completed and attached:

(Tick where appropriate and/or insert score)
Yes: [ ] No: [ ] Assessment Score: [ ]

_____________________________
Signature and stamp of Supervisor